Wanetta King, LCSW

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

2552-C Issued in NV

Practice address

15301 Warren Shingle Rd
Beale AFB, CA 95903-1907

Phone

(530) 634-3423

Fax

(530) 634-0670

NPI assigned

May 16, 2006

Last updated

Feb 21, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1366494924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15301 WARREN SHINGLE RD",
            "city": "BEALE AFB",
            "state": "CA",
            "postal_code": "959031907",
            "telephone_number": "530-634-3423",
            "fax_number": "530-634-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15301 WARREN SHINGLE RD",
            "city": "BEALE AFB",
            "state": "CA",
            "postal_code": "959031907",
            "telephone_number": "530-634-3423",
            "fax_number": "530-634-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "WANETTA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NV",
            "license": "2552-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Dominic Jobrack, D.O, MPH
• Melissa G Johnson, PSYD
• Leonid M. Katkovsky, M.D.
• Shalaleh Khoei
• Jaehong Kim, D.D.S.
• David Scott Klajic, PHD
• Patricia Ann Knepshield, ATC
• Nicolas Lara, MD
• Allysyn Lasch-Vujevic, LCSW
• Michelle Lynn Laughlin, LCSW

• Military Health Care Provider in Beale AFB, CA
• Providers in Beale AFB, CA by specialty
• Military Health Care Provider in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.